OWBCs Vision A Stronger Borough Together Councillors, staff, - - PDF document

OWBC Lightbulb Presentation (October 2018) 02/10/2018 Full Council | Tuesday, 02 October 2018 1

OWBC’s Vision

“A Stronger Borough Together “

Councillors, staff, residents, businesses, partners and stakeholders will continue to create a stronger borough by working together A stronger Borough that is inclusive and engaged and focuses on delivering effective services, balanced economic development, green and safe places resulting in better wellbeing for all.

OWBC Lightbulb Presentation (October 2018) 02/10/2018 Full Council | Tuesday, 02 October 2018 2

• Housing Offer to Health 2013
• £1m Transformation Challenge Award from DCLG
• National and local strategic drivers support the case for Lightbulb

service transformation Areas being encouraged to think strategically about use of home adaptations and technologies through the BCF Leicestershire’s ageing population; increased demand on services (OWBC 12,000 over 65 rising to 12,600 in 2020*) Costs to NHS of poor housing, falls and LTC are significant DFG work can delay the need for residential care and is cost effective but DFG process can be unnecessarily lengthy

Background

*Figures provided by Institute of Public Care

THE LIGHTBULB OFFER

• The lightbulb philosophy, offer, operating model and all processes within

it have been co-designed between adult social care, health and all 7 Districts

• The offer is a targeted, proactive approach including via GPs and other

health/care professionals such as those in integrated locality teams

• Early assessment and triage of housing issues at key points of entry
• Hub and spoke model - integrated locality Lightbulb team in each District

Council area (OWBC has 1FTE Housing Support Coordinator, 0.3Tech Officer, 0.4 Admin , 9% of Locality Hub)

• Common functions (management, performance, development etc) sit

within the central ‘hub’

OWBC Lightbulb Presentation (October 2018) 02/10/2018 Full Council | Tuesday, 02 October 2018 3

THE LIGHTBULB OFFER

• Housing Support Co-ordinator (HSC) role encompasses functions

previously carried out across District and County Councils - supported by OT and technical officer expertise (the locality team)

• HSC job role include trusted assessor element, supported by competency

framework

• Customer focussed assessment and solutions through the Housing MOT

checklist

• Offer supports both step down from hospital and step up in community

settings

• Integrated working with other key stakeholders such as

community fire and rescue/home safety teams also in place

Lightbulb Governance –Service Hosted by BDC

Delegation and Collaboration Agreement

Management Board (rep from OWBC) Delivery Group (rep from OWBC) Lightbulb Team

OWBC Lightbulb Presentation (October 2018) 02/10/2018 Full Council | Tuesday, 02 October 2018 4

Housing MOT

Housing MOT

Personal Safety Home Security Warmth Local Community Other

The Previous Journey The Lightbulb Journey

Mr T was discharged from hospital following aortic valve replacement surgery. Mr T’s wife contacted the Customer Service Centre for assistance with bathing:

• Positive customer experience
• Holistic assessment included support

to claim attendance allowance, falls prevention advice

• More handoffs and longer waiting

time

• Single issue approach

BENEFITS ILLUSTRATION

OWBC Lightbulb Presentation (October 2018) 02/10/2018 Full Council | Tuesday, 02 October 2018 5

Evidence of utcomes – Housing support co-ordinators

• On average each resident benefited from 3 housing support

interventions (excluding advice and signposting)

• 30 cases were analysed using the NHS number and PI’s Care and

Health Trak tool, this showed a reduction in service usage of 66%

• Two months post intervention saw adult social care costs reduced

by 23%

• Scaled up to include all potential Housing Support Co-ordinator

cases, this could lead to cost savings of up to £250,000 to Adult Social Care per year

• 18 cases analysed where residents had previously fallen. 17

reported no falls since they received their interventions

• A reduction of 1 fall per year for these 17 people alone would result

in a cost saving of £21,000 per year for the local health and care economy

• All reported feeling safer and more confident around the home

OADBY & WIGSTON CASE STUDY - BATHING ASSESSMENT & EQUIPMENT Start Date: 5.02.18 - End Date: 20.2.18

WHAT WERE THE MAIN ISSUES FOR THE INDIVIDUAL? ( E.G. IDENTIFIED BY THE MOT CHECKLIST)

SU has recently had a series of mini strokes and has been staying at daughters home, since leaving hospital. The SU wishes to return home and be more independent. The SU also suffers with arthritis and swelling in his left arm and has double vision at times, causing issues with bathing transfers, bed transfers and toilet access and transfers.

WHAT ACTIONS WERE TAKEN?

Visit and MOT completed and assessed for a wooden half step and grab rails for the front door, also a metal rail along the front path which leads to the front door. Bath lift provided to assist with bathing transfers and a bed lever. Equipment also provided for toilet.

WHO ELSE WAS INVOLVED

Advice given on contacting adult social care for support with some care when SU returns home. The adaptations have meant that the risk of falls is reduced and this SU can return home to live life as independently as possible, with additional care where needed.

OWBC Lightbulb Presentation (October 2018) 02/10/2018 Full Council | Tuesday, 02 October 2018 6

Housing Support Co-Ordinators Performance

The chart below shows for all districts:-

• The time take for a case to be referred to lightbulb, to being picked up for a housing

MOT by a HSC (blue)

• The time taken for a HSC to process the case and close it (red). OWBC is on par with

the average for all districts here

10 20 30 40 50 60 70 Blaby Charnwood H&B Harb Melton NWL O&W

Qtr 1 2018 - Average times for HSC's (days)

Avge Ref to MOT Time (days) MOT to case closed (days) Average of all districts (Case open to closed time in days)

Evidence of outcomes – OWBC

Disabled Facilities Grant type Pre-Lightbulb Post -Lightbulb Number Average

• No. Days

Number Average

• No. Days

Level Access Shower 17 264.86 28 219.80 improved Stair lift 3 239.50 11 128.00 improved Other 3 433.00 12 106.00 improved Total 23 51

OWBC Lightbulb Presentation (October 2018) 02/10/2018 Full Council | Tuesday, 02 October 2018 7

Lightbulb Service Costs

Blaby, 47,541 Charnwood, 95,082 Harborough, 36,570 Hinckley & Bosworth, 65,826 Melton, 32,913 North West Leicestershire, 54,855 Oadby & Wigston, 32,913 Leicestershire County Council, 365,700

HOSPITAL HOUSING ENABLER TEAM

• Central part of Lightbulb Offer
• Targeted to a key Better Care Fund aim and metric e.g. delayed transfers of care
• Housing Enablers & Community Support workers based in hospital settings, both

acute and mental health

• Quickly established as essential members of integrated discharge team
• Seek a wide variety of innovative and pragmatic housing solutions
• Access to budgets to help with rent deposits & furniture
• Formal evaluation using PI care and Health data and simulation modelling
• Links with wider Lightbulb offer and Housing Support Coordinator role
• Excellent results!

OWBC Lightbulb Presentation (October 2018) 02/10/2018 Full Council | Tuesday, 02 October 2018 8

Evidence of outcomes – Hospital Housing Enabler

• 411 cases have been dealt with by the team up to the 31.12.17
• Reasons for referrals –homelessness/home no longer

suitable/family refusing return

• High demand for clean & clear budget

UHL service three months post intervention analysis on 357 patients saw:

• - 57% reduction in A&E attendances
• - 54%reduction in A&E admissions
• - 27% increase in no activity
• - 84% reduction in NHS costs for this cohort of patients 3 months

post intervention – saving £222,000, scaled up this could mean a potential £550,000 saved over 12 months

Evidence of outcomes – Hospital Housing Enabler 115 patients at the Bradgate Unit analysed saw:

• 920 delayed bed days saved
• Of 40 service users who continued to receive support in the

community following discharge only one was readmitted

• Over 12 months the projected housing DTOC costs would be

£175,000 compared to £650,000; a potential reduction of £475,000

• Referrals to the Bradgate Unit have risen by 67% in last 6
• months. In contrast resolution times have reduced by 60%

meaning despite the rise in referral patients are receiving a speedier service reducing the chance of delays

OWBC Lightbulb Presentation (October 2018) 02/10/2018 Full Council | Tuesday, 02 October 2018 9

“Thank you, a bath lift may seem such a simple thing, but it has made such a difference to my life!” They bought the equipment yesterday, they were ever so good - and someone has been and put up a grab rail. Thank you ever so much for

• everything. The shower chair is so

helpful.

“Being independent whilst undertaking very personal activities means so much to me, so this service in my eyes is indispensable. I want to praise the work that your department does. You should all be proud of the difference you make to people’s lives.” “Thank you for the adaptations that you fitted at my 93 year old mother’s home, she has mobility issues and is a blue badge holder. They have been a god send. It was really great to have all this sorted by one team and the Housing Support Coordinator who visited my mother sorted everything out. “ “We really didn’t expect any help after Mum was discharged from hospital, I don’t know where we would be without you.”

“My mental health condition did not allow me to clean my house, and got so bad I couldn’t return home when I was medically

• fit. Without the hospital

housing team I’d still be in hospital”

“I was left to sort out my own rent arrears, I would have been evicted if it was not for the Housing Team at the

• hospital. ”

“ Lightbulb got me all the help I needed and I only had to deal with one person.”

WHAT OUR CUSTOMERS SAY …………

Leicestershire Partnership Trust City Clinical Commissioning Group Acute Hospitals Foundations Community Mental Health Teams West Clinical Commissioning Group Community Health Teams Occupational Therapists (Health) East Clinical Commissioning Group GP Practices Community Hospitals Public Health

OWBC Lightbulb Presentation (October 2018) 02/10/2018 Full Council | Tuesday, 02 October 2018 10

• Award Winning

Partnership!

• Offers resilience
• Service is delivered

quicker

• Service is more

encompassing

• Service will develop

Lightbulb Partner’s Future Plans

• Community Hospitals
• Move on Accommodation
• Merge and Manage Adaptations Work
• Merge and Manage other Hospital Team
• Lead Assistive Technology Initiatives
• Commitment – Additional DFG Funding
• Public Health Engagement
• Lightbulb RRO
• Dementia Friendly Homes
• Extension of Hospital Enabler Team
• Social Prescribing
• Extension of Programme across all Tenures

OWBC Lightbulb Presentation (October 2018) 02/10/2018 Full Council | Tuesday, 02 October 2018 11

Questions or for further detail contact:

Jane Toman Chief Executive and Senior Responsible Officer for Lightbulb Blaby District Council jane.toman@blaby.gov.uk Quin Quinney Housing and Community Services Group Manager Blaby District Council quin.quinney@blaby.gov.uk